本文選題：股骨頭缺血性壞死 + 動(dòng)物模型�。� 參考：《安徽醫(yī)科大學(xué)》2006年碩士論文

【摘要】：研究背景：股骨頭缺血性壞死的治療是骨科臨床難題之一，目前尚未發(fā)現(xiàn)一種可終止或者逆轉(zhuǎn)已發(fā)生股骨頭壞死病理過(guò)程，從而阻止股骨頭進(jìn)一步塌陷的有效方法。雖然我們已知在股骨頭壞死區(qū)的修復(fù)與重建過(guò)程中，壞死骨的吸收導(dǎo)致股骨頭強(qiáng)度的下降是塌陷的主要原因，減少或終止壞死骨的吸收可延遲或避免壞死股骨頭塌陷的發(fā)生。但我們對(duì)其發(fā)病機(jī)理和何種方法能有效治療股骨頭缺血性壞死尚不十分清楚，原因之一可歸咎于缺乏一個(gè)能真正能反映股骨頭壞死的病理過(guò)程的動(dòng)物模型。 目的：為股骨頭壞死的治療研究建立一種新型的動(dòng)物模型。 方法：出生后4周的幼兔通過(guò)適應(yīng)性訓(xùn)練和特定的懸吊，模擬人類直立行走，兩條后腿負(fù)重行走。飼養(yǎng)至成年后用液氮將一側(cè)股骨頭冷凍，術(shù)后2周繼續(xù)懸吊，定期拍X線片和取股骨頭行組織切片了解股骨頭壞死的情況。 結(jié)果：術(shù)后3天切片見(jiàn)股骨頭完全壞死，造模側(cè)3天后標(biāo)本顯示軟骨細(xì)胞、骨細(xì)胞及骨髓壞死，，空骨陷窩增加，空骨陷窩率最低71％，最高93％。骨小梁結(jié)構(gòu)完整。3周后標(biāo)本出現(xiàn)軟骨、骨髓和骨修復(fù)現(xiàn)象，骨修復(fù)表現(xiàn)兩種方式，一種是骨小梁周圍出現(xiàn)同位附加骨，一種是骨髓腔以膜內(nèi)化骨或軟骨化骨形式出現(xiàn)骨小梁。術(shù)后3周X線片示骨密度增高。5周后修復(fù)作用增強(qiáng)，部分壞死骨小梁開(kāi)始吸收，出現(xiàn)較多破骨細(xì)胞，骨小梁不規(guī)則，出現(xiàn)骨折，關(guān)節(jié)軟骨面磨損加重，少數(shù)標(biāo)本關(guān)節(jié)軟骨面塌陷。7周時(shí)關(guān)節(jié)軟骨面磨損與修復(fù)并存，骨髓纖維化和增生互見(jiàn)，髓腔膜內(nèi)化骨和骨小梁同位附加骨增多，骨小梁紊亂變細(xì)，骨吸收和骨折加重。術(shù)后7周X線片出現(xiàn)典型的新月征和股骨頭壞死塌陷的表現(xiàn)。 結(jié)論：液氮冷凍“直立行走兔”短期內(nèi)復(fù)制出了與人股骨頭壞死一致的動(dòng)物模型，為股骨頭壞死的治療研究提供了新型的動(dòng)物模型。
[Abstract]:Background: the treatment of avascular necrosis of femoral head is one of the clinical problems in orthopedic department. At present, there is no effective method to stop or reverse the pathological process of femoral head necrosis and prevent the further collapse of femoral head. Although it is known that the reduction of the strength of the femoral head due to the absorption of the necrotic bone is the main cause of the collapse during the repair and reconstruction of the necrotic area of the femoral head, the reduction or termination of the absorption of the necrotic bone can delay or avoid the collapse of the necrotic femoral head. However, the pathogenesis and the effective treatment of avascular necrosis of the femoral head are not well understood. One of the reasons can be attributed to the lack of an animal model which can truly reflect the pathological process of femoral head necrosis. Objective: to establish a new animal model for the treatment of femoral head necrosis. Methods: four weeks after birth, the rabbits were simulated to walk upright and with two hind legs by adaptive training and specific suspension. After feeding to adulthood, one femoral head was frozen with liquid nitrogen and suspended 2 weeks after operation. X-ray films were taken regularly and the femoral head tissue sections were taken to find out the condition of femoral head necrosis. Results: the femoral head was completely necrosed 3 days after operation. After 3 days of modeling, the specimens showed the necrosis of chondrocytes, bone cells and bone marrow, the increase of empty bone lacunae, the lowest rate of 71% of empty bone lacunae, and the highest 933%. The bone trabeculae showed cartilage, bone marrow and bone repair phenomenon after 3 weeks of bone trabecular structure integrity. There were two ways of bone repair, one was that the bone trabeculae around the bone trabeculae appeared at the same position, the other was the bone trabeculae appeared in the form of membranous internalized bone or chondrogenic bone in the medullary cavity. At 3 weeks after operation, the bone density was increased and the repair effect was enhanced, some necrotic trabeculae began to absorb, more osteoclasts appeared, bone trabeculae were irregular, fracture appeared, and articular cartilage wear was aggravated. In a few specimens, the articular cartilage surface was worn and repaired at week 7, bone marrow fibrosis and proliferation were observed, the number of bone and trabeculae were increased, the bone trabecular disorder became thinner, bone resorption and fracture aggravated. Typical crescent sign and avascular necrosis of femoral head appeared on X-ray film 7 weeks after operation. Conclusion: liquid nitrogen cryopreservation "upright walking rabbit" made the animal model consistent with human femoral head necrosis in a short period of time, and provided a new animal model for the treatment of femoral head necrosis.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2006
【分類號(hào)】：R-332

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